On this page:

Making a referral to cancer genetics

Taking and assessing a personal and family history of cancer

Undertaking genetic testing in cancer or endocrine tumour patients

Requesting advice from the cancer genetics team

Education and training resources for healthcare professionals

Information for GP practices participating in our FHQS primary care pilot

Making a referral to cancer genetics

Making a referral to clinical genetics is different to making a referral for genetic testing. An assessment by clinical genetics will require a formal referral to our service, as below.

Genetic tests can be sent directly according to the National Genomic Test Directory. Sending a sample for genetic testing will not result in an automatic referral to the clinical genetics service, which will need to be made independently if required.

We prefer referrals via email: cancergenetics.stg@nhs.net or via ERS. We also accept written referrals by post.

NOTE: Genetic testing is always most informative in an individual affected with cancer. Please refer affected individuals to our service over their unaffected relatives wherever possible.

We will accept any referrals for:

  • Patients at high risk of developing cancer due to their personal and / or family history
  • Patients meeting National Genomic Test Directory Criteria for inherited cancer genetic testing
  • Patients with a relative who has a likely pathogenic or pathogenic variant in a known cancer predisposition gene who require predictive testing
  • Patients who are known to carry a likely pathogenic or pathogenic variant in a known cancer predisposition gene

Referrals from primary care
Referrals from secondary care

Essential referral information

The following information is essential to include with any referral:

Referral for assessment or diagnostic testing:

  • If patient is affected with cancer, please enclose pathology report if available
  • Type of cancer in patient or affected relatives
  • Age at diagnosis of all affected relatives
  • Number of relatives and degree of relatedness (first degree, second degree)
  • Ashkenazi Jewish / Polish ancestry

Referral for predictive testing:

Information about gene carrier relative

  • Name
  • Date of birth
  • Gene with pathogenic variant
  • Genetic centre test was performed

Referrals from primary care

Please review our referral guidelines prior to making your referral. Asking the patient to complete our simple family history screening questions can also help decide if referral is required.

Referrals from secondary care / oncology / surgery

Tumour types with links to:

Please also consider referring:

  • Families with childhood cancers (solid tumours), particularly if there are other cancer diagnoses in the family
  • Any family with more cases of cancer than expected, particularly if occurring at young ages

This list is not exhaustive and you are welcome to request advice from the cancer genetics team prior to a referral if you are concerned about a personal and/or family history of cancer.

Referral guidelines

For further assessment, we will only accept referrals to our service which meet our specific referral criteria:

Taking and assessing a personal and family history of cancer

Screening for potential genetic predisposition prior to referral

We have developed some simple screening questionnaires which the patient can complete to assess if they are likely to have an increased genetic predisposition to cancer. If a patient answers “no” to all of these six questions, genetic predisposition is unlikely although please do contact us for further advice if you still concerned.

If a patient answers “yes” to any of these questions they require a full family history assessment. This does not mean they will always have increased risk, but indicates further assessment is required.

Patients who are being referred to our service will be invited to complete our online Family History Questionnaire Service (FHQS). This service is currently ONLY for patients referred to our service and we cannot provide any assessment to patients who complete this without an accompanying referral.

Any previously completed family history information should be sent with any subsequent referral to our service.

Genetic testing will only be offered to individuals meeting National Genomic Medicine Service Eligibility Criteria. Individuals who are not eligible for testing may still be eligible for increased screening.

We have developed guidelines for assessing a family history of cancer in primary and secondary care.

Please see our current screening guidelines

We have developed a training module in assessing a family history of breast and/or ovarian cancer which can be completed towards personal CPD

This list is not exhaustive and you are welcome to request advice from the cancer genetics team prior to a referral if you are concerned about a personal and/or family history of cancer.

You can also use the Cancer Genetics app developed by Guys and St Thomas’s hospital to assist with your assessment

Undertaking genetic testing in cancer or endocrine tumour patients

Patients who meet National Genomic Test Directory Criteria for inherited cancer/tumour genetic testing may be offered testing directly by their treating team in secondary care according to the test directory guidelines. This is known as “mainstreaming”.

We have developed a suite of resources to support clinicians who wish to undertake genetic testing themselves.

Please note that if you request testing directly without referring to clinical genetics using these referral forms, the result will be returned directly to you. If your patient requires a referral to clinical genetics this must be made separately to requesting the test:cancergenetics.stg@nhs.net

General resources

Testing for a specific indication as per National Genomic Test Directory Criteria

Please note that the forms for each indication can ONLY be used for the gene panel specified on the form. For other indications please use a blank form and fill out the relevant details and test indication yourself

Ovarian cancer

The following resources are available for genetic testing in ovarian cancer. If further advice is required please contact cancergenetics.stg@nhs.net

Breast cancer

We continue to accept referrals for breast cancer patients using our routine or RAPID assessment pathways. RAPID assessments will be treated as urgent, contacted by clinical genetics within a week from receipt of referral for consultation. Please ensure a sample has been sent and a referral made to cancergenetics.stg@nhs.net. RAPID referrals will ensure genetic counselling takes place but will inevitably take longer than direct testing.

If you request testing directly without referring to clinical genetics using the referral forms above, the result will be returned directly to you. The following resources are available for genetic testing in breast cancer. If further advice is required please contact cancergenetics.stg@nhs.net

Pancreatic Cancer

The following resources are available for genetic testing in pancreatic cancer. If further advice is required please contact cancergenetics.stg@nhs.net

R367: Inherited pancreatic cancer

Endocrine Tumour Predisposition Syndromes

The following resources are available for genetic testing in endocrine tumour predisposition syndromes. If further advice is required please contact cancergenetics.stg@nhs.net

R218: Medullary Thyroid Cancer

R223: Inherited phaeochromocytoma and paraganglioma

R151: Familial hyperparathyroidism

Endometrial cancer

Kidney cancer

Colorectal cancer

Paediatric cancer

Skin cancer

Requesting advice from the cancer genetics team

We have a dedicated cancer genetics on call service available for advice from our clinicians.

This service runs 0900-1700 Monday-Friday.

We can be contacted on:|
Email: cancergenetics.stg@nhs.net
Telephone: 020 8725 5333 or 07787 843 070

Education and training resources for healthcare professionals

Below is a curated list of education and training resources for healthcare professionals in cancer genetics:

Genomics: Foundation Knowledge

Cancer Genetics

Bowel Cancer UK

Information for GP practices participating in our FHQS primary care pilot

This information is for GP practices who are trialling our FHQS in their practice. If you are interesting in discussing this further with our team please contact us via email: cancergenetics.stg@nhs.net

Resources coming soon